Double-stranded hamstring graft for anterior cruciate ligament reconstruction

Bellier, G; Christel, P.; Colombet, Philippe; Djian, P.; Franceschi, J.-P.; Sbihi, Abdou

doi:10.1016/s0749-8063(04)00604-8

Cited by 97 publications

(48 citation statements)

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“…However, these techniques involve only AMB reconstruction and are inherently poor at restoring stability in response to a combined rotatory and internal rotation force with valgus torque, such as would occur during a pivot shift [21]. In order to improve knee stability and to approximate the complex biomechanical role of the ACL, several authors have recently proposed an anatomical ACL reconstruction that involves both AMB and posterolateral bundle (PLB) reconstruction [1,2,7,16,18,22,23].…”

Section: Introductionmentioning

confidence: 99%

Kinematic study following double-bundle, anterior cruciate ligament reconstruction

Seon

Song

Bae

et al. 2006

International Orthopaedics (SICO

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The purpose of this study was to evaluate tibiofemoral kinematics after double-bundle anterior cruciate ligament (ACL) reconstructions and compare them with those of successful single-bundle reconstructions and contralateral normal knees using open MR images. We obtained MR images based on the flexion angle without weight-bearing, from 20 patients with successful unilateral single-bundle (10 patients) and double-bundle (10 patients) ACL reconstructions with tibialis anterior allografts and a minimum 1-year follow-up. The MR images of the contralateral uninjured knees were used as normal controls. Sagittal images of the mid-medial and mid-lateral sections of the tibiofemoral compartments were used to measure the translation of the femoral condyles relative to the tibia. The mean translations of the medial femoral condyles on the tibial plateaus during knee joint motion showed no significant differences among normal, single-bundle, and double-bundle ACL reconstructed knees (all p>0.05). The mean translations of the lateral femoral condyles showed a significant difference between normal and single-bundle reconstructed knees, or between single-bundle and doublebundle reconstructed knees (p<0.05). However, there was no significant difference between normal and doublebundle reconstructed knees (p=0.220). These findings suggest that double-bundle ACL reconstruction restores normal kinematic tibiofemoral motion better than singlebundle reconstruction.Résumé Le but de cette étude était d'évaluer, par les images de résonnance magnétique, la cinématique tibiofémorale après reconstruction du ligament croisé antérieur par double tunnel et de la comparer avec celle obtenue après réussite des reconstructions à un seul tunnel et celle du genou normal controlatéral. Nous avons étudié des images basées sur l'angle de flexion en décharge chez 20 patients après reconstruction par allogreffe tibiale antérieure suivis au moins un an : 10 avec succés de la reconstruction par un seul tunnel et 10 avec reconstruction par un double tunnel. Les images du genou controlatéral non traumatisé servaient de contrôle. Des images sagittales de la partie moyenne des compartiments fémoro-tibiaux permettaient la mesure de la translation des condyles fémoraux par rapport au tibia. La translation du condyle interne pendant la flexion du genou n'était pas différente entre le genou normal et la reconstruction par simple ou double tunnel (p>0,05). La translation du condyle externe était significativement différente entre le genou normal et la reconstruction par simple tunnel et entre les reconstructions par simple et double tunnel (p<0,05). Cependant il n'y avait pas de différence entre le genou normal et la reconstruction par double tunnel (p=0,220). Ces résultats suggèrent que la reconstruction du croisé antérieur par double tunnel restore mieux la cinématique du genou que la reconstruction par simple tunnel.

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Section: Introductionmentioning

confidence: 99%

Kinematic study following double-bundle, anterior cruciate ligament reconstruction

Seon

Song

Bae

et al. 2006

International Orthopaedics (SICO

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“…Therefore, several authors have suggested that an anatomical double-bundle ACL reconstruction has some biomechanical advantages over a single-bundle ACL reconstruction [1,2,6,7,13,14,17,18,[23][24][25]. Although they reported the superior results of a double-bundle reconstruction with respect to Lachman's test and the pivot shift phenomenon compared with a single-bundle reconstruction after a mid-term follow-up, they did not provide objective quantitative data about the rotational stability [18,25].…”

Section: Discussionmentioning

confidence: 99%

“…Several authors have reported good clinical results [1,2,6,7,13,14,17,18,[23][24][25] but few have provided a quantitative evaluation of the rotational stability compared with those of a single-bundle technique.…”

Section: Introductionmentioning

confidence: 99%

Stability comparison of anterior cruciate ligament between double- and single-bundle reconstructions

Seon

Park

Lee

et al. 2008

International Orthopaedics (SICOT)

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The purpose of this study was to evaluate the intra-operative stability during double-bundle anterior cruciate ligament (ACL) reconstructions (20 knees) using a navigation system and compare the results with those obtained from single-bundle reconstructions (20 knees). After registering the reference points during ACL reconstruction, antero-posterior and rotational stability tests with 30°knee flexion using a navigation system were measured before and after reconstructions on both groups. The change of antero-posterior translation after and before reconstruction was 12.5 mm in the double-bundle group and 10.5 mm in the single-bundle group, showing significant inter-group difference (p=0.014, from 17.5 mm to 5.1 mm in the double-bundle and from 16.6 mm to 6.1 mm in the single-bundle group). The mean rotational stability of the double-bundle group also showed more significant improvement after reconstruction compared to that of the single-bundle group (9.8°in the double-and 5.6°in the single-bundle groups, p<0.001). These findings suggest that a double-bundle ACL reconstruction restores greater knee stability with respect to the antero-posterior and rotational stability than a single-bundle reconstruction.Résumé Le propos de cette étude est d'évaluer la stabilité per opératoire de la reconstruction du ligament croisé antérieur par deux faisceaux à propos de 20 genoux avec utilisation d'un système de navigation. Ces résultats ont été comparés à ceux obtenus par une reconstruction par un seul faisceau (20 genoux). Après enregistrement des différents points de références, la stabilité des genoux est testée à 30°d e flexion en utilisant le système de navigation avant et après la reconstruction dans les deux groupes. La modification de la translation antéro postérieure après et avant la reconstruction était de 12,5 mm dans le groupe à deux faisceaux et de 10,5 mm dans le groupe à un seul faisceau, montrant une différence significative (p=0,014, 17,5 mm à 5,1 mm dans les réfections avec deux faisceaux et de 16,6 mm à 6,1 mm dans les réfections à un seul faisceau). La stabilité en rotation a également été améliorée dans le groupe de reconstruction à deux faisceaux (9,8°contre 5,6°dans le groupe à un seul faisceau, p<0,001). Ces données confirment que la reconstruction des ligaments croisés antérieurs par la technique à deux faisceaux permet d'avoir un genou beaucoup plus stable tant sur le plan antéro postérieur que sur le plan rotatoire si l'on compare cette technique à celle de la reconstruction avec un seul faisceau.

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“…Although the ACL anatomy and function have been widely studied, publications dealing with replacement of more than 1 ligament bundle are mostly descriptions of techniques [25][26][27][28][29][30][31] or case series reports. 20,[22][23][24] Most authors make use of semitendinous and gracilis tendon grafts [24][25][26][28][29][30]32 or alografts.…”

Section: Techniques and Graftsmentioning

confidence: 99%

“…20,[22][23][24] However, most studies consist either of case series reports with no comparative control groups or of mere descriptions of the technique, such as technical notes. [25][26][27][28][29][30][31] We developed an ACL reconstruction technique using a double femoral bone tunnel and a patellar bone-quadri-ceps tendon graft with its tendinous portion split longitudinally in an attempt to more accurately reproduce the normal anatomy of the anteromedial and posterolateral bundle. We compared this technique to widely employed conventional single-bundle technique.…”

Section: Introductionmentioning

confidence: 99%

Anterior Cruciate Ligament Reconstruction With Double Bundle Versus Single Bundle: Experimental Study

Albuquerque

Sasaki

Amatuzzi

et al. 2007

Clinics

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Mota e Albuquerque RF, Sasaki SU, Amatuzzi MM, Angelini, FJ. Anterior cruciate ligament reconstruction with double bundle versus single bundle: experimental study. Clinics. 2007;62(3):335-44. OBJECTIVE:To test an intra-articular reconstruction of the anterior cruciate ligament of the knee in 10 human cadavers by replacing 2 anterior cruciate ligament bundles, with the purpose of producing a surrogate that would be structurally more similar to the anatomy of the anterior cruciate ligament and would provide the knee with more stability. METHODS: We reconstructed the anteromedial and posterolateral bundles using a quadriceps muscle tendon graft that included a patellar bone segment. The anteromedial bundle was replaced in 10 knees (5 right and 5 left knees from different cadavers) by a quadriceps-bone tendon graft, and the anteromedial and posterolateral bundles were replaced in the matching pairs of these knees. In the latter, the bone segment was fixed to the tibia, and the tendinous portion of the graft was divided longitudinally creating two 5-mm wide bundles that were inserted individually into the femur through 2 independent bone tunnels. Then, the knees were tested mechanically to evaluate the tibial anterior dislocation in relation to the femur, as well as the rigidity of the graft. The control group was formed by the knees with intact anterior cruciate ligaments, before being resected to be reconstructed. RESULTS:The results obtained did not show superiority of double-bundle reconstruction over single-bundle reconstruction, and neither technique provided the knee with the same stability and rigidity of the intact anterior cruciate ligament. CONCLUSION: Our hypothesis, based on the anatomy and biomechanics of the knee, that reconstruction of the anterior cruciate ligament using 2 bundles would result in a more anatomic reconstruction and provide better containment of the anterior tibial translation was not supported by the results of this study.

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Double-stranded hamstring graft for anterior cruciate ligament reconstruction

Cited by 97 publications

References 0 publications

Kinematic study following double-bundle, anterior cruciate ligament reconstruction

Kinematic study following double-bundle, anterior cruciate ligament reconstruction

Stability comparison of anterior cruciate ligament between double- and single-bundle reconstructions

Anterior Cruciate Ligament Reconstruction With Double Bundle Versus Single Bundle: Experimental Study

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